61850 CPT® code: payer coverage and prior authorization8 of 8 payer prior-auth lists that name 61850 require prior authorization or set conditions: Blue Cross and Blue Shield of Texas, Humana, Rocky Mountain Health Plans, UnitedHealthcare Community Plan.
61850 appears in 35 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Mississippi, Blue Shield of California, BlueCross BlueShield of South Carolina, Capital Blue Cross, Premera Blue Cross, Regence, UnitedHealthcare.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Deep Brain Stimulation (0208) | covered if criteria are met | Mar 27, 2026 | payer document |
| Aetna | Epilepsy Surgery (0394) | covered if criteria are met | Jun 23, 2026 | payer document |
| Aetna | Grid Monitoring and Intraoperative Electroencephalography (0289) | listed, no stance (range 61850-61888) | Apr 17, 2026 | payer document |
| Aetna | Headaches: Invasive Procedures (0707) | not covered | Jul 23, 2026 | payer document |
| Aetna | Intraoperative Neurophysiological Monitoring (0697) | covered if criteria are met (range 61850-61888) | Jun 19, 2026 | payer document |
| Aetna | Intravenous Iron Therapy (0575) | listed, no stance (range 61000-64999) | Jul 1, 2026 | payer document |
| Aetna | Motor Cortex Stimulation (0755) | not covered | Feb 24, 2026 | payer document |
| Aetna | Parkinson's Disease (0307) | not covered | Feb 24, 2026 | payer document |
| Aetna | Respiratory Devices: Incentive Spirometers, Vaporizers and Intermittent Positive Pressure Breathing Machines (0479) | listed, no stance (range 61000-64999) | Jul 9, 2026 | payer document |
| Aetna | Thermal Perfusion Probe for Monitoring Regional Cerebral Blood Flow (0703) | listed, no stance (range 61000-64999) | Nov 24, 2025 | payer document |
| Aetna | Tinnitus Treatments (0406) | not covered | Jul 10, 2026 | payer document |
| Aetna | Trigeminal Neuralgia: Treatments (0374) Trigeminal Tractotomy, CT-guided percutaneous pulsed radiofrequency, Pulsed radiofrequency with continuous radiofrequency thermocoagulation, Transcranial direct current stimulation | not covered | Jun 29, 2026 | payer document |
| Anthem | Deep Brain Stimulation and Responsive Neurostimulation (SURG.00026) | covered if criteria are met | Aug 13, 2026 | payer document |
| Blue Cross & Blue Shield of Mississippi | Deep Brain Stimulation | covered if criteria are met | payer document | |
| Blue Cross & Blue Shield of Mississippi | Responsive Neurostimulation For The Treatment Of Refractory Focal Epilepsy (A.7.01.143) | listed, no stance | payer document | |
| Blue Shield of California | | Deep Brain Stimulation (7.01.63) | listed, no stance | payer document | |
| BlueCross BlueShield of South Carolina | Deep Brain Stimulation (CAM 70163) | listed, no stance | Jun 1, 2026 | payer document |
| Capital Blue Cross | Deep Brain Stimulation (MP 1.042) Procedure codes | covered if criteria are met | Jun 1, 2026 | payer document |
| Premera Blue Cross | Deep Brain Stimulation (7.01.609) | listed, no stance | Sep 8, 2026 | payer document |
| Premera Blue Cross | Responsive Neurostimulation for the Treatment of Refractory Focal Epilepsy (7.01.143) | listed, no stance | Oct 14, 2026 | payer document |
| Regence | Responsive Neurostimulation (Surgery 216) | listed, no stance | Jan 1, 2026 | payer document |
| UnitedHealthcare | Deep Brain and Cortical Stimulation (2026T0321LL) | listed, no stance | Feb 1, 2026 | payer document |
| UnitedHealthcare | Deep Brain and Cortical Stimulation (CS030.T) | listed, no stance | Apr 1, 2026 | payer document |
| UnitedHealthcare | Deep Brain and Cortical Stimulation (for Idaho Only) (CS030ID.D) | listed, no stance | Jun 1, 2026 | payer document |
| UnitedHealthcare | Deep Brain and Cortical Stimulation (for Indiana Only) (CS030IN.10) | listed, no stance | Jun 1, 2026 | payer document |
| UnitedHealthcare | Deep Brain and Cortical Stimulation (for Kansas Only) (CS030KS.02) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Deep Brain and Cortical Stimulation (for Kentucky Only) (CS030KY.12) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Deep Brain and Cortical Stimulation (for Nebraska Only) (CS030NE.T) | listed, no stance | Apr 1, 2026 | payer document |
| UnitedHealthcare | Deep Brain and Cortical Stimulation (for New Jersey Only) (CS030NJ.M) | listed, no stance | Apr 1, 2026 | payer document |
| UnitedHealthcare | Deep Brain and Cortical Stimulation (for New Mexico Only) (CS030NM.C) | listed, no stance | Apr 1, 2026 | payer document |
| UnitedHealthcare | Deep Brain and Cortical Stimulation (for North Carolina Only) (CSNCT0321.07) | listed, no stance | Jul 1, 2026 | payer document |
| UnitedHealthcare | Deep Brain and Cortical Stimulation (for Ohio Only) (CS030OH.E) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Deep Brain and Cortical Stimulation (for Pennsylvania Only) (CS030PA.R) | listed, no stance | Sep 1, 2026 | payer document |
| UnitedHealthcare | Deep Brain and Cortical Stimulation (for Tennessee Only) (CS030TN.Q) | listed, no stance | Apr 1, 2026 | payer document |
| UnitedHealthcare | Deep Brain and Responsive Cortical Stimulation (MMP395.02) | listed, no stance | Sep 1, 2026 | payer document |
Prior authorization required or conditional in IN, VT, WY.
From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.